Symptomatic accessory navicular bone: A case series

Mansoor, Sahibzada Nasir; Qureshi, Masood Ahmed

doi:10.1016/j.rehab.2014.03.707

Cited by 3 publications

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“…It is known that severity and duration of medial foot pain are associated with the decision for surgical treatment. [25] However, we could not acquire adequate information regarding pain severity due to the retrospective nature of the study. If the degree of foot pain severity had been more accurately assessed, the significance of SUVmax regarding the association with surgery might have been more relevantly evaluated.…”

Section: Discussionmentioning

confidence: 99%

Maximum standardized uptake value of foot SPECT/CT using Tc-99m HDP in patients with accessory navicular bone as a predictor of surgical treatment

et al. 2019

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Quantitative bone SPECT/CT (single-photon emission computed tomography/computed tomography) using Tc-99m hydroxymethylene diphosphonate is emerging as a useful imaging modality for skeletal diseases. Accessory navicular bone (ANB) has been evaluated by bone scintigraphy only qualitatively and semiquantitatively. However, a truly objective quantitative assessment of ANB is lacking. Here, we measured the maximum standardized uptake value (SUVmax) of the ANB and investigated its usefulness as an imaging biomarker for ANB.Consecutive quantitative bone SPECT/CT studies that had been performed on the foot were retrospectively analyzed. One hundred five patients (male:female = 44:61; median age = 32.0 [range, 11–81] years old; 31 negative controls without ANB and 74 patients with ANB [7 unilateral and 67 bilateral]) and their 210 feet were investigated. The ANBs were classified into types I, II, III (Geist classification), and 0 (contralateral navicular of unilateral ANB). Type II ANBs were subclassified into II-1 (with bony abnormality) or II-0 (without bony abnormality). The treatment modality was observation, conservative treatment, or surgical removal. The associations between the SUVmax and clinical findings, including surgery, were investigated.Patients with type II-1 ANB had the highest SUVmax among all ANB types (P < .001). The SUVmax of symptomatic ANB was greater than that for asymptomatic ANB (P < .001), and the SUVmax for the surgically resected ANB group was also significantly higher than that for the observation only or conservative treatment group (P < .001). Subtype II-1 had a significantly higher SUVmax compared with subtype II-0 (P < .001). Logistic regression analyses in type II ANB showed that young age (P = .020) and SUVmax (P = .031) were significant predictors for surgery. Receiver operating characteristic curve and survival analyses revealed an optimal SUVmax cutoff of 5.27 g/mL for predicting final surgical treatment.SUVmax derived from quantitative bone SPECT/CT was strongly associated with symptom, surgical treatment, and a known high-risk type of ANB. Risk stratification for final surgical treatment of ANB can be achieved using the SUVmax from quantitative bone SPECT/CT.

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Section: Discussionmentioning

confidence: 99%

Maximum standardized uptake value of foot SPECT/CT using Tc-99m HDP in patients with accessory navicular bone as a predictor of surgical treatment

et al. 2019

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“…In most instances, this is an incidental finding, however, usually after a trauma, intense physical activity, or in patients in certain occupations, it can cause serious symptoms, such as pain, a decreased range of motion, discomfort with shoe wearing, and flatfoot deformity. During the diagnosis, the presence of the accessory navicular needs to be considered because it is usually interpreted as the straining of the foot or the ankle joint [3]. Radiographic assessment is sufficient to define three types of the accessory navicular [4].…”

Section: Introductionmentioning

confidence: 99%

FE Analysis of the Symptomatic Navicular - A Case Report

Prodanovic

Savić

Ristić

et al. 2024

Experimental and Applied Biomedical Research (EABR)

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The accessory navicular (AN) is a bony formation located on the medial side of the foot, proximal to the navicular and continuous with the posterior tibialis tendon. It emerges as a developmental variant due to the presence of the secondary ossification center adjacent to the primary center of the navicular. It is regarded as a physiological and anatomical variant. In most instances, this is an incidental finding. Radiographic values are used to define three types of AN based on its relationship with the navicular. The symptomatic AN causes pain in the medial portion of the bone, a decreased range of motion and discomfort with shoe wearing. In case of recurrent symptoms, following an inadequate diagnosis and treatment, it can result in acquired flatfoot. Our case study examined the condition of asymptomatic AN in a young man with both flatfeet, who was initially treated conservatively, and then, after the failed response to the therapy, surgically. Following the Kidner procedure (excision with the reattachment of the insertion in the posterior tibialis tendon) and rehabilitation, the patient reports no subjective symptoms in the period of 12- month monitoring. An objective examination was conducted with the use of FE analysis during weight-bearing. We determined a reduction in total weight-bearing and the pressure distribution to the lateral side of the foot, metatarsal, and the heel region.

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Accessory ossicles and sesamoid bones: recognition and treatment

Summers

2015

Emergency Nurse

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Accessory ossicles and sesamoid bones are normal variants of bone development. In foot and ankle X-rays these bones can appear similar to, or can obscure, fractures, which makes the X-rays difficult to interpret. This article illustrates and describes some of the more common ossicles and sesamoid bones, and provides a brief description of the management of the patients with foot or ankle pain whose X-rays are inconclusive.

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Symptomatic accessory navicular bone: A case series

Cited by 3 publications

References 0 publications

Maximum standardized uptake value of foot SPECT/CT using Tc-99m HDP in patients with accessory navicular bone as a predictor of surgical treatment

Maximum standardized uptake value of foot SPECT/CT using Tc-99m HDP in patients with accessory navicular bone as a predictor of surgical treatment

FE Analysis of the Symptomatic Navicular - A Case Report

Accessory ossicles and sesamoid bones: recognition and treatment

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